Medicare Advantage in Tucson

Who were the Medicare Advantage winners and losers in Tucson, AZ after the Medicare Open Enrollment Period (OEP)?   The 2014 OEP was chaotic for over 10,000 people in Pima County who changed their Advantage plan. Many of them had been notified that their Advantage plan was being cancelled, or their doctor was no longer in their plan’s network.

I wrote about the Medicare Advantage plan cancellations in Pima County back in October,  and now that the dust has settled, the numbers from CMS (Centers for Medicare and Medicaid Services) provide a clear picture of  winners and losers in the enrollment competition for Medicare Advantage in Tucson.

I expected the big loss numbers for Health Net and UnitedHealthcare (which is the AARP Medicare Complete HMO-POS Plus).  I thought Blue Cross Blue Shield of Arizona might have enrolled even more than 7,000 people into its brand new plan (for Pima County).

What was news to me was that the Blue Cross Blue Shield of Arizona Medicare Advantage plan is actually Banner Medisun.   Banner Medisun has the contract for the Medicare Advantage plan and they use the name “Blue Cross Blue Shield of Arizona”.

UPDATE/CORRECTION:

I got an email from the Chief Compliance officer at Blue Cross Blue Shield of Arizona Advantage explaining the Banner -Medisun – Blue Cross Blue Shield relationship.  The email said there is no longer a “Banner MediSun”. Banner Health Network sold 50% of MediSun to Blue Cross Blue Shield of Arizona in 2013, creating a new company: Veritage, LLC.

Veritage owns MediSun, as an independent BCBS licensee, and is doing business as “Blue Cross Blue Shield of Arizona Advantage”. This is a different company from Blue Cross Blue Shield of Arizona.

So it appears that Banner is not part of this arrangement – except that when my clients get calls from BCBS of Arizona Advantage, the caller id says “Banner”.  One of my clients did not answer the call because she was expecting a call from BCBS of Arizona (and not Banner).  And the CMS data says the contract is under “Medisun”. And  another client says his doctor’s office told him their contract is with Medisun.  And the Banner-Medisun web page is still around and it links to the BCBS of Arizona Advantage home page.

I guess Blue Cross Blue Shield of Arizona Advantage is a multi-partner arrangement – which is not a bad thing if the different partners bring strong skills sets to the organization. My concern is that my clients have a smooth transition in their new Medicare Advantage plan – and I sure hope there won’t be major changes for 2016.

This last Medicare Open Enrollment Period was the most tumultuous I’ve seen in my ten years in this business – and I sure don’t want a repeat of that experience.

Here are numbers comparing December 2014 enrollments with January 2015:

Dec. 2014 Jan. 2015 change
MEDISUN, INC(Blue Cross Blue Shield of Arizona Advantage)     0 7076
PACIFICARE OF ARIZONA, INC.    25591 29719  4128  +16%
UNITEDHEALTHCARE OF ARIZONA, INC.    11739 7350  -4389  -37%
HUMANA HEALTH PLAN, INC.    6119 5857  -262  -4%
HEALTH NET OF ARIZONA, INC.    12234 4895  -7339  -60%
SCAN HEALTH PLAN ARIZONA    1063 675  -388  -37%
CAREMORE HEALTH PLAN OF ARIZONA, INC.    10760 10834   74  +1%
PHOENIX HEALTH PLANS, INC.     53 72   19  +36%

NOTES:

Pacificare is the AARP Medicare Complete Plan 1.

The Humana numbers are for its HMO plan, contract number H2649. Humana also has regional and local PPOs in Pima County.

 

The CMS EXCEL spread sheet with Medicare Advantage enrollment numbers in each county in the country can be found here:

http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/MCRAdvPartDEnrolData/Monthly-MA-Enrollment-by-State-County-Contract.html

 

 

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